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Installment Note

This is an installment note. The form provided here is simply a sample of what the actual form looks like.

INSTALLMENT NOTE

$____________(1)_____________ Date: ______(2)_______

I promise to pay the sum of _______(3)_______ ($_______________)

to the order of ________(4)_________ at

________(5)_____________ in the following manner:

The sum of $_____________(6)____________

on the _____(7)_____ day of _____(8)______, _____(9)_____;

and the sum of $_____(10)_____

on the __(11)__ of each month thereafter until the entire amount is repaid, said sum including interest at the rate of

________(12)________ % per annum.

The maker and endorser of this note further agree to waive demand, notice of nonpayment and protest, and in case suit shall be brought for the collection hereof, or the same has to be collected upon demand of an attorney, to pay reasonable attorney's fees for making such collection.